Provider Demographics
NPI:1093903668
Name:CARDON, LEE H (CPO)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:H
Last Name:CARDON
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69730 HIGHWAY 111 STE 107
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-2873
Mailing Address - Country:US
Mailing Address - Phone:760-328-6575
Mailing Address - Fax:
Practice Address - Street 1:69730 HIGHWAY 111 STE 107
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-2873
Practice Address - Country:US
Practice Address - Phone:760-328-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist